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The Alliance News: September 2010

On My Mind:
Keeping the Conversation Going

Our Alliance Learning Circle on August 18, The Patient Protection and Affordable Care Act: Balancing the Big Picture with Immediate Implications, was a well attended and dynamic event. We probably could have continued presenting information, discussing and networking for at least a week.

We received good feedback on our speaker John Barlament from Michael Best & Friedrich from attendees in our post-survey. Respondents also rated the format very highly, which broke up the information portion with a chance to ask questions of both John and each other. We will continue to look at the possibility of holding similar sessions in the coming years as more information becomes available. 

If you were not able to attend, please visit the In The Circle page of our website for our executive summary, presentations and other handouts from the event as well a few new ones from our speaker. You can also find all of our legislative updates on our PPACA Updates page. Check back often, as this information is updated frequently.

We are also looking forward to continuing the discussion with lawmakers at candidate forums. The first, on September 29, will give you a chance to hear from and speak directly to candidates running for office this coming fall. We are in the process of confirming attendance with lawmakers and candidates for office and will let you know more about the slate of candidates following the primaries on September 14. Learn more about that event as well as our Alliance Learning Circle: Benefit Plan Compliance — Control is Within Your Reach in the article below. 

The candidate forum on September 29, and others like it, are part of our continuing efforts to help lawmakers better understand the employer perspective when it comes to critical health care policy issues, and to help members better understand important policy initiatives being discussed on both the federal and state levels. We look forward to seeing you there.

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Mark Your Calendar for these Upcoming Events

This fall you’ll have plenty of opportunities to get together with members and learn at Alliance events.

September 21: The Cost of Outpatient Care Webinar
10:30 – 11:30 a.m.
Webinar
Join us to take a closer look at the 2010 QualityCounts Outpatient Tests and Procedures Report released last month. In the past 10 years new technology and less-invasive techniques have made outpatient care the fastest growing segment of health care, with some of the highest profit margins. In this webinar you’ll learn how you can use it to reduce your outpatient costs.

We’ll provide an overview and history of the report, look at headlines from the 2010 report, and share tools to help you take this report to employees and their families. Learn more and register today. 

September 29: Benefit Plan Compliance — Control is Within Your Reach
8 – 11:30 a.m.
Monona Terrace Community & Convention Center
At this event, you’ll learn more about the group health plan requirements of ERISA, COBRA and HIPAA as well as how to feel like you’re on top of compliance issues. You’ll learn how to:

• Assess and prioritize your compliance concerns.
• Develop your organization’s compliance strategy.
• Feel more in control and confident about ever-changing compliance issues.

Our speaker, Erin Freiberg, JD, from Freiberg Law Office, LLC,  is known for explaining complicated topics in an easy-to-understand manner. Both those who are newer to benefits and more seasoned professionals looking for a new way to stay on top of compliance issues will benefit from this session. Learn more and register today. 

September 29: Candidate Forums
Noon – 4 p.m.
Monona Terrace Community & Convention Center
Following our morning Alliance Learning Circle, we’ll be holding an afternoon of candidate forums.

You’ll have a chance to hear from and speak directly to candidates running for office this coming fall. This is part of our continuing efforts to help lawmakers better understand the employer perspective when it comes to critical health care policy issues, and to help members better understand important policy initiatives being discussed on both the federal and state levels.

We are in the process of inviting candidates and will let you know when the slate of candidates has been decided upon.

When you register, let us know if you plan to attend only the morning session, the candidate forums, or both events. A boxed lunch will be provided for those who attend both the morning compliance session and afternoon candidate forum. You may register for either or both events. Register today. 

October 26: Annual Meeting
This year in addition to continuing the celebration of our 20th anniversary and holding our annual business meeting, we’ll take a look at behavioral economics. This science studies how real people actually make choices, which is often different from the way we assume they make them – rationally.

Drawing from psychology and economics, behavioral economics is showing that humans often make flawed decisions that they believe are rational, and that run counter to their best interest. Our Annual Meeting will focus on how behavioral economics influences people’s choices about their health now and in the future and how you can use these concepts to design your benefit plans. Watch for more details, coming soon.

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Building Our Cooperative

Please join us in welcoming the following new members to the cooperative:

Waukesha County Technical College (WCTC)
Waukesha County Technical College (WCTC) is a non-profit, community college located in Waukesha and Pewaukee, Wis. Dedicated to student learning, WCTC provides lifelong learning opportunities that are high quality, affordable and accessible. As one of the 16 schools in the Wisconsin Technical College System, WCTC enrolls over 30,000 students and has specialized focus in technical education, occupational training, and enrichment programs. WCTC joined The Alliance in July.

Wisconsin State Telecommunication Association (WSTA)
Located in Madison, Wis., the Wisconsin State Telecommunication Association (WSTA) serves as a trade association that represents 83 local telephone companies, 31 Internet service providers, and 10 wireless carriers. The association interacts with its nationwide network of telecommunication experts and serves as a clearinghouse for the most accurate information for its members. WSTA serves as a unified voice for its members in matters of interest to legislators, regulators, and the public. WSTA joined The Alliance in July.

Mallery & Zimmerman, S.C. is an established law firm engaged in the general practice of civil law with offices in Wausau, Green Bay, Milwaukee, Mosinee, and Stevens Point, Wis. Mallery & Zimmerman, S.C. play an active role in the growth and welfare of businesses and non-profit organizations in their communities. Their employees are educated and experienced in various law practices from banking and finance, to divorce and adoption. Many of these employees are successful authors, lecturers and leaders in the legal field. Mallery & Zimmerman, S.C. joined The Alliance in August.

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Are You Making an Administrator Change?

Keeping The Alliance abreast of third-party administrator (TPA) changes helps to ensure that claims for your plan members are forwarded to the appropriate party following repricing. Your prompt notification helps to contribute to a seamless transition of your group to the new TPA resulting in no disruption in claims processing and payment.

Once you’ve decided that administrator change will occur for your plan, please contact Jesse Oberloh, member services manager at 800.223.4139 x 6645 or via e-mail. Jesse will coordinate the transition with appropriate Alliance staff.

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Health Coaching for Healthy Participants

It is estimated that our formalized healthcare system affects only about 10% of our measurable health. The remaining 90% of health outcomes is determined by factors over which healthcare providers have little or no control, such as lifestyle choices, social conditions, and the physical environment.

Could health coaching build a bridge to a new system of healthcare? 
Alternative Therapies: 15(16-18) Lawson, K. (2009)

Enter health coaching. The goal of health coaching is to enhance the well-being of individuals and to facilitate achievement of their health-related goals, regardless of the level of health. Individuals across the wellness spectrum can gain something from health coaching — even Olympic athletes utilize coaches to optimize their health and performance! Participants who have experienced successes from health coaching range from those with multiple risks, to those who are looking to stay on track by maintaining an already healthy lifestyle.

Optimal Health Coaches at our wellness partner, Health Solutions Ltd®, have a wide area of expertise and are ready to assist participants at all levels of health. Participants who are already maintaining a healthy lifestyle can work with health coaches to establish and stay on track with current or new goals, identify areas of improvement that may have been overlooked, and increase accountability to ensure that success is achieved. 

The ultimate goal for participants who are already maintaining a high level of health is to work with a health coach to achieve a level of transcendence in which participants are able to help others achieve better health and wellness.

For more information about Health Solutions Ltd®, Optimal Health Coaching or information about our partnership with them, contact Bobbi Jones, product management specialist, 800.223.4139 x 6638. As a reminder, as part of our new partnership philosophy, The Alliance receives no commissions from Health Solutions, Ltd., instead passing on all the savings to members. You can learn more about how we chose Health Solutions, Ltd. here.  

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Quantum Health Makes the List! Recognized as a Top Disease Management Organization

Quantum Health has just proven that bigger isn’t better (and small can be mighty) by making the Health Industry Research Companies’ (HIRC) list of leading disease management organizations. Until recently, size was a primary factor for making the list, according to HIRC’s Fall 2010 report on Health and Disease Management Service. But now, organizations must obtain auditors’ letters from respected third parties to vouch for the validity of their outcomes. Quantum Health is one of just seven companies to meet this new, highly stringent quality standard.

In the same report, HIRC also recognized Quantum Health’s Coordinated Health/Care™ solution as a Leading Employer/Third Party Administrators (TPA) Disease Management Program. Of the eight self-insured employers cited by HIRC as having a leading employer/TPA disease management program, two are Quantum Health clients:  City of Savannah and Oshkosh Corporation.

The Alliance has been partnering with Quantum Health for about a year to offer their Coordinated Health/Care™ program to Alliance member companies with 200 or more employees across all networks. Even if a portion of these employees are in The Alliance network, the contract and savings can be applied to all employees. For more information, contact Bobbi Jones, product management specialist, at 800.223.4139, x 6638. You can also learn more here. 

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Delta Dental Earns High Marks from Dentists

Delta Dental of Wisconsin not only has the largest network in the state – they also have the most satisfied dentists. In a recent survey of all dental offices in Wisconsin, 93 percent of dentists who responded said they were “very satisfied” or “satisfied” overall with Delta Dental, well above any other carrier. In fact, the percentage of dentists who said they were “very satisfied” with Delta Dental was more than five times higher than the next highest-rated insurance carrier.

On the other side of the scale, only 2 percent of dentists said they were dissatisfied or very dissatisfied with Delta Dental, compared to nearly 50 percent of dentists who felt that way about one leading carrier and 20 percent for another.

Dentists and dental office staff gave Delta Dental high marks in virtually every category measured. In all, more than 30 separate aspects of performance were examined, including:

• Customer service
• Commitment to promoting oral health
• Claims administration
• Services provided specifically to dental offices by Delta Dental’s Professional Relations team

Narrative responses to open-ended questions in the survey provided additional insight into the reasons why dentists and dental office staff favored Delta Dental over other carriers. Survey respondents criticized other carriers for slow response to phone inquiries, inadequate answers to questions, and overseas handling of customer service inquiries, while praising Delta Dental’s Wisconsin-based call center for its performance.

“I wish all our insured patients had Delta Dental,” said one respondent. Another said “Delta Dental of Wisconsin is the best carrier of all we deal with at our office. We have even recommended to other carrier reps to contact Delta to get hints and tips on all levels. We just love Delta Dental of Wisconsin!”

The Alliance offers members a preferred relationship with Delta Dental as well as Delta Vision. For more information, see our product sheet, or contact Bobbi Jones, product management specialist, 800.223.4139 x 6638.

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2010 SPD Analysis Report Coming Soon

The 2010 SPD Analysis Report is almost finalized. We are putting the final touches on the report, which will include data from 71 members who completed the survey. If you completed the survey, you will receive your copy in the next few weeks.

This report summarizes the plans offered by Alliance employers including the most common:

• Stop-loss coverage
• Percentage of premium paid
• Plan designs, including deductible levels, prescription drug co-pays and precertification requirements for hospital admissions

If you did not participate in the survey, but would like a report, contact Jesse Oberloh, 800.223.4139 x 6645. You may also contact Jesse if you would like to receive a customized report.

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Open Positions

The Alliance is currently hiring for a number of positions. You can learn more about them here.

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Watch for Your Patronage Check

Equity members, your patronage checks were sent this week in a special green anniversary mailer. Be sure to read it and take out the check.

Once a year, Alliance Equity members receive this check which is share of the net proceeds of the cooperative. The Alliance Board of Directors determines the amount that will be paid out and how much will be kept on the books to ensure the future value of the cooperative and to accomplish our mission of controlling costs, improving quality and engaging individuals in their health.

If you have any questions, please contact Jesse Oberloh, member services manager, 800.223.4139 x 6645.

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Alliance Provider Update

The Alliance encourages employers to distribute the monthly Provider Update listing to their employees.

Just a reminder: Always check the online provider directory for the most current provider information!

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QualityCounts™ for Employees

The Alliance encourages employers to distribute the monthly QualityCounts for Employees informational piece to their employees.

This month, With the release of the 2010 QualityCounts Outpatient Tests and Procedures Report comes a new QualityCounts for Employees.

Here, each month, you’ll find materials you can print out directly and share with employees. This month, we’ve included a flyer you can use to let employees know that the new report is available and how to access it. Simply print out and make copies and hang up around your workplace. Get your copy here.

You can also find the complete QualityCounts toolkit in the Employer Resource Center under Employer Tools. You will need to log in first. If you do not know your log-in, contact Tierney Jensen.

The Alliance is available to come and give a presentation to your employees about QualityCounts. For information, contact Bobbi Jones, 800.223.4139 x 6638.

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News You Can Use

Each month, The Alliance highlights health care and benefit management news for employers in News You Can Use, with a link to take you to the original story or report.

The annual National Business Group on Health Survey focused in on employer actions related to PPACA. Read more.

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Alliance Member Forum

Discuss this newsletter in the Alliance Member Forum on LinkedIn.

• Do you agree with the employers in the NBGH Survey?
• How has PPACA changed your plans?

Provide your response and ask other members for their thoughts.

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Alliance Referral Program

Don't forget about The Alliance Referral Program.

Help your cooperative grow by referring a member candidate to The Alliance. Alliance members who refer a prospective member receive a $1,000 credit if the company joins The Alliance. To refer someone, use our form.

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About The Alliance News

Each month, The Alliance News delivers the latest news about Alliance services, programs and events, as well as information on health benefit trends, issues and ideas.

Subscriptions are free for Alliance employer members. To subscribe, please send an e-mail with your name, title and organization to the marketing and member services department.

Reader comments, suggestions and topics are always welcome.

Cathy Lanser, Editor

Tierney Jensen, Design

Jesse Oberloh, Member Services Manager

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